A 58-year-old woman with type 2 diabetes has A1c 7.4% on metformin. She has hypertension and a prior myocardial infarction. eGFR is 78 mL/min/1.73 m2

Question

A 58-year-old woman with type 2 diabetes has A1c 7.4% on metformin. She has hypertension and a prior myocardial infarction. eGFR is 78 mL/min/1.73 m2 and she has no hypoglycemia. Which of the following is the most appropriate next step in management?

Accepted Answer

Add an SGLT2 inhibitor or GLP-1 receptor agonist with cardiovascular benefit

Answer

Start niacin for glycemic control

Answer

Use prandial insulin despite near-goal A1c

Answer

Add glyburide before breakfast

Answer

Stop metformin and start sliding-scale insulin

Type 2 diabetes with ASCVD — USMLE Step 3 MCQ

A 58-year-old woman with type 2 diabetes has A1c 7.4% on metformin. She has hypertension and a prior myocardial infarction. eGFR is 78 mL/min/1.73 m2 and she has no hypoglycemia. Which of the following is the most appropriate next step in management?